Current Technology Developments Can Improve the Quality of Research and Level of Evidence for Rehabilitation Interventions

被引:16
作者
Bonnechere, Bruno [1 ,2 ]
Timmermans, Annick [1 ]
Michiels, Sarah [1 ,3 ]
机构
[1] Hasselt Univ, Fac Rehabil Sci, REVAL Rehabil Res Ctr, B-3590 Diepenbeek, Belgium
[2] Hasselt Univ, Data Sci Inst, Technol Supported & Data Driven Rehabil, B-3590 Diepenbeek, Belgium
[3] Antwerp Univ Hosp, Dept Otorhinolaryngol, B-2650 Edegem, Belgium
关键词
rehabilitation; new technology; validation; study design; methods; MEDICATION ADHERENCE; ADAPTIVE DESIGNS; CLINICAL-TRIALS; BLACK-BOX; BIAS; RISK; ETHICS; POWER;
D O I
10.3390/s23020875
中图分类号
O65 [分析化学];
学科分类号
070302 ; 081704 ;
摘要
The current important limitations to the implementation of Evidence-Based Practice (EBP) in the rehabilitation field are related to the validation process of interventions. Indeed, most of the strict guidelines that have been developed for the validation of new drugs (i.e., double or triple blinded, strict control of the doses and intensity) cannot-or can only partially-be applied in rehabilitation. Well-powered, high-quality randomized controlled trials are more difficult to organize in rehabilitation (e.g., longer duration of the intervention in rehabilitation, more difficult to standardize the intervention compared to drug validation studies, limited funding since not sponsored by big pharma companies), which reduces the possibility of conducting systematic reviews and meta-analyses, as currently high levels of evidence are sparse. The current limitations of EBP in rehabilitation are presented in this narrative review, and innovative solutions are suggested, such as technology-supported rehabilitation systems, continuous assessment, pragmatic trials, rehabilitation treatment specification systems, and advanced statistical methods, to tackle the current limitations. The development and implementation of new technologies can increase the quality of research and the level of evidence supporting rehabilitation, provided some adaptations are made to our research methodology.
引用
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页数:14
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共 108 条
[1]   Multiple wearable sensors in parkinson and huntington disease individuals: A pilot study in clinic and at home [J].
Adams, Jamie L. ;
Dinesh, Karthik ;
Xiong, Mulin ;
Tarolli, Christopher G. ;
Sharma, Saloni ;
Sheth, Nirav ;
Aranyosi, A.J. ;
Zhu, William ;
Goldenthal, Steven ;
Biglan, Kevin M. ;
Dorsey, E. Ray ;
Sharma, Gaurav .
Digital Biomarkers, 2017, 1 (01) :52-63
[2]   Enabling precision rehabilitation interventions using wearable sensors and machine learning to track motor recovery [J].
Adans-Dester, Catherine ;
Hankov, Nicolas ;
O'Brien, Anne ;
Vergara-Diaz, Gloria ;
Black-Schaffer, Randie ;
Zafonte, Ross ;
Dy, Jennifer ;
Lee, Sunghoon I. ;
Bonato, Paolo .
NPJ DIGITAL MEDICINE, 2020, 3 (01)
[3]   Global Public Attitudes About Clinical Research and Patient Experiences With Clinical Trials [J].
Anderson, Annick ;
Borfitz, Deborah ;
Getz, Kenneth .
JAMA NETWORK OPEN, 2018, 1 (06)
[4]   ICF-inspired goal-setting in developmental rehabilitation: an innovative framework for pediatric therapists [J].
Angeli, Jennifer M. ;
Schwab, Sarah M. ;
Huijs, Lobke ;
Sheehan, Amber ;
Harpster, Karen .
PHYSIOTHERAPY THEORY AND PRACTICE, 2021, 37 (11) :1167-1176
[5]   Intention-to-treat analysis may be more conservative than per protocol analysis in antibiotic non-inferiority trials: a systematic review [J].
Bai, Anthony D. ;
Komorowski, Adam S. ;
Lo, Carson K. L. ;
Tandon, Pranav ;
Li, Xena X. ;
Mokashi, Vaibhav ;
Cvetkovic, Anna ;
Findlater, Aidan ;
Liang, Laurel ;
Tomlinson, George ;
Loeb, Mark ;
Mertz, Dominik .
BMC MEDICAL RESEARCH METHODOLOGY, 2021, 21 (01)
[6]   Twenty-five years of confirmatory adaptive designs: opportunities and pitfalls [J].
Bauer, Peter ;
Bretz, Frank ;
Dragalin, Vladimir ;
Koenig, Franz ;
Wassmer, Gernot .
STATISTICS IN MEDICINE, 2016, 35 (03) :325-347
[7]   Trial designs using real-world data: The changing landscape of the regulatory approval process [J].
Baumfeld Andre, Elodie ;
Reynolds, Robert ;
Caubel, Patrick ;
Azoulay, Laurent ;
Dreyer, Nancy A. .
PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, 2020, 29 (10) :1201-1212
[8]   Making Decision-Making Visible-Teaching the Process of Evaluating Interventions [J].
Benfield, Angela ;
Krueger, Robert B. .
INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH, 2021, 18 (07)
[9]   Emerging innovations in clinical trial design [J].
Berry, D. A. .
CLINICAL PHARMACOLOGY & THERAPEUTICS, 2016, 99 (01) :82-91
[10]   Adaptive Designs for Clinical Trials [J].
Bhatt, Deepak L. ;
Mehta, Cyrus .
NEW ENGLAND JOURNAL OF MEDICINE, 2016, 375 (01) :65-74